Role of bundled intervention in reducing surgical site infection rate in gynecologic surgeries

Background: Surgical site infection (SSI) is most common nosocomial infection (15%) among surgical patient’s and contributes significantly to morbidity and mortality. CDC (2015) provides “bundled intervention for prevention of SSI. The present study was planned to evaluate the feasibility and usefulness of these bundled intervention in reducing SSI in our setup. Objectives of this study to study the effect of bundled interventions on SSI in gynaecologic surgery.Methods: A total 50 cases  undergoing gynecological surgery in elective OT included in pilot group and bundled intervention followed  these pilot group cases compared with 50 control group operated in same OT in which bundled intervention not followed outcome measures recorded were Incidence of SSI, type of SSI, need for antibiotic usage, need for secondary suturing, duration of hospital stay.Results: Out of 50 subjects in pilot group, five developed signs and symptoms of SSI giving an SSI rate of 10%. Out of those five, two had superficial SSI and three had deep SSI, none of the patient had organ space SSI.SSI rate in 50 cases operated in the same operating room during the same time period without use of bundled interventions (control group) was 12%.Conclusions: Bundled approach is easy and feasible in all setups. It adds only three extra minutes to the total duration of the surgery with risk reduction of SSI

ESBL, MBL AND AMP C-β LACTAMASES PRODUCED BY SUPERBUGS: AN EMERGING THREAT TO CLINICAL THERAPEUTICS

Objectives: The present study was undertaken to determine the prevalence of multi drug resistant (MDR) and multiple β-lactamase producing Pseudomonas aeruginosa isolates in lower respiratory tract infection (LRTI) patients at a tertiary care hospital in India.Methods: A total of 80 consecutive, non-duplicate isolates of P. aeruginosa were studied for the presence of class A or B β-lactamase. Antibiotic susceptibility tests and PCR amplification of genes encoding class A (PER-1 and CTX-M 1, 2, 9) and class B β-lactamases (blaVIM-2, blaIMP-1 and blaSIM-1) were performed.Results: Out of 80 P. aeruginosa isolates, 65% (52/80) of the isolates were MDR with 34 being Metallo-β-lactamase (MBL) producers, 23 were extended spectrum β-lactamase (ESBL) producers and 21 were positive for AmpC production. The cross-class resistance rates to other antibiotics was significantly higher in class A and B β-lactamase producers than in non-producers (P<0.05 for fluoroquinolone, aztreonam, ceftazidime and meropenem). Combined disk test (CDT) for MBL highest sensitivity and specificity compared to PCR. Combined disk method (CDM) for ESBL co-related well with PCR (sensitivity and specificity).Conclusion: This study reports the validation of a simple and accurate MBL and ESBL detection method which can be easily integrated into the daily routine of a clinical laboratory.Â

Drug delivery system: targeting of pentamidines to specific sites using sugar grafted liposomes

Different sugar-grafted liposomes were prepared and tested against experimental leishmaniasis in vivo using the classical drug pentamidine isethionate and its methoxy derivative. Both the drugs, when encapsulated in sugar-grafted liposomes were found to be more potent in comparison to normal liposome-encapsulated drug or to the free drug. Moreover, the mannose-grafted liposomes were adjudged to be the best in lowering of spleen parasite load in comparison with those bearing glucose or galactose. When encapsulated in mannose-grafted liposomes the therapeutic efficacy of pentamidine isethionate was found to be better than that of its methoxy derivative, although the latter seemed to be less toxic than the pentamidine isethionate itself

Stigma associated with sexually transmitted infections among patients attending suraksha clinic at a tertiary care hospital in northern India

Context: Illnesses affecting sexual organs and its correlation with improper sexual behavior lead to a negative attitude and discriminating behavior towards people affected by such disorders. Aim: The aim was to study the stigma associated with sexually transmitted infections (STIs) among patients attending Suraksha clinic at a tertiary care hospital in northern India. Settings and Design: This was a hospital-based cross-sectional study. Subjects and Methods: The present study was conducted at Suraksha (STI) clinic, King George's Medical University, Uttar Pradesh. A total of 487 STI patients (clinically and/or laboratory-confirmed) were contacted telephonically, of which 49 finally participated in the study. Stigma was assessed using modified and pretested version of India HIV-related stigma scale adapted in context to sexually transmitted diseases. Statistical Analysis: Quantitative variables were expressed as mean with standard deviation, and independent sample t-test was used to compare the mean values. P < 0.05 was considered statistically significant. Results: Mean scores of enacted, vicarious, felt normative, and internalized stigma for 49 patients (out 487) who finally participated in the study were 0.04±0.11, 0.55±0.70, 1.21±0.96, and 0.86±0.67, respectively. Unmarried/divorced/separated patients had significantly higher vicarious and felt normative stigma scores as compared to married individuals. Mean score for felt normative stigma was significantly higher among homosexual/bisexuals in comparison to heterosexual individuals. Conclusions: Efforts should be directed towards the provision of integrated services through sexual health-oriented campaigns to address the stigma associated with STI in a more comprehensive way

Sulfonamide Drugs Binding to the Colchicine Site of Tubulin: Thermodynamic Analysis of the Drug-Tubulin Interactions by Isothermal Titration Calorimetry

The discovery of several sulfonamide drugs paved the way toward thesynthesis of 6(N-12-[(4-hydroxyphenyl)amino]-3-pyridinyl]-4-methoxybenzenesulfonamide:E7010) and 7(N-(3fluoro-4-methoxyphenyl)pentafluorobenzenesulfonamide, T138067),both of which inhibit, tubulin polymerization and are under clinicaldevelopment. A series of diarylsulforiamides containing an indolescaffold was also found to have antimitotic properties, but, their modeof interactions with tubulin has remained unidentified so far. In thisstudy: we demonstrate that these sulfonamide drugs bind to thecolchicine site of tubulin in a reversible manner. They quenchedintrinsic tryptophan fluorescence of tubulin presumably due todrug-induced conformational changes in the protein, but were unable tomodulate GTPase activity of tubulin in contrast to colchicine thatenhances the same enzymatic activity. Further investigation usingisothermal titration calorimetry (ITC) revealed that 5(N-(5-chloro-7-indolyl)-4-methoxybenzenesulfonamide) afforded a largepositive value of heat capacity change (\Delta C_p) = +264, cal mol^-^1 K^-^1) on binding to tubulin, suggesting a substantial conformationaltransition in the protein along with partial enthalpy- entropycompensation. On the other hand. the 2-chloro regioisomer 2 gave alarge negative value of \Delta C_p(-589 cal mol^-^1 K^-^1) along withcomplete enthalpyentropy compensation. This thermodynamic profile wasthought to be attributable to a prominent contribution of van der Waalsinteraction and hydrogen bonding between Specific groups in thedrug-tubulin complex. These results indicate that a mere alteration inthe position of a single substituent chlorine on the indole scaffoldhas a great influence on the drug-tublin binding thermodynamics

I-123-mIBG myocardial imaging for assessment of risk for a major cardiac event in heart failure patients: insights from a retrospective European multicenter study

Single-center experiences have shown that myocardial meta-iodobenzylguanidine (mIBG) uptake has prognostic value in heart failure (HF) patients. To verify these observations using a rigorous clinical trial methodology, a retrospective review and prospective quantitative reanalysis was performed on a series of cardiac (123)I-mIBG scans acquired during a 10-year period at six centers in Europe. (123)I-mIBG scans obtained on 290 HF patients [(262 with left ventricular ejection fraction (LVEF) or = 1.75 (n = 73), there were nine MCEs because of progressive HF and only one because of an arrhythmia. Application of a clinical trial methodology via the retrospective reanalysis of (123)I-mIBG images confirms the previously reported prognostic value of this method in HF patients, including potential identification of a quantitative threshold for low risk for cardiac mortality and potentially fatal ventricular arrhythmia

Supplementary Data 1 from Molecular Results and Potential Biomarkers Identified from the Phase 3 MILO/ENGOT-ov11 Study of Binimetinib versus Physician Choice of Chemotherapy in Recurrent Low-Grade Serous Ovarian Cancer

Supplementary Tables and Figures</p